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A magnetically tunable multi-band switchable frequency terahertz (THz) absorber based on graphene is proposed, and its absorption performance is analyzed using the 4 × 4 transfer matrix method. The results indicate that the proposed absorber achieves absorption amplitude tuning across multiple switchable THz frequencies by adjusting the static bias magnetic field. Moreover, both absorption and modulation depths exceed 90% for the left-handed circularly polarized wave. This performance can be attributed to the unequal Landau levels distribution of graphene in the quantum domain and the properties of photonic crystals, which include photonic bandgaps and optical localization. This study may have significant potential in various frequency-switchable components, such as circular polarization sensors, circular polarizers, and magnetic circular dichroism optical detectors. [ABSTRACT FROM AUTHOR]

Objective: At the start of the COVID-19 pandemic, healthcare workers (HCW) in our ED were advised against and actively discouraged from wearing masks when not seeing respiratory patients, as mask wearing was thought to increase the risk of droplet transmission by face touching. The primary objective of the present study was to determine whether HCW using face masks were more or less likely to touch their faces than those not wearing masks. Methods: We analysed six randomly selected hours of closed circuit television footage from our staff base. Face touches were recorded electronically by trained researchers. Generalised linear mixed models were used to compare the frequency and duration of face touches with and without face masks, controlling for individual clusters, adjusting for time of footage, duration on screen and staff role. Results: Data were collected from 187 HCW. Masks were worn in 231 (36%) of 642 screen sessions. Wearing a mask did not significantly change the odds of face touching (odds ratio 0.55, 95% confidence interval [CI] 0.30-1.01, P = 0.055) or duration of face touch (mean difference -1.45 s, 95% CI -8.84, 5.99, P = 0.71). For mucosal areas, a significant reduction in the odds of face touching was observed for mask wearers (odds ratio 0.21, 95% CI 0.11-0.43, P < 0.001) and on the frequency of mucosal touches (rate ratio 0.45, 95% CI 0.29-0.69, P < 0.001). Conclusions: Mask wearing did not change face touching or the duration of face touches. However, significantly fewer mucosal touches were observed when wearing a mask, which may help to reduce nosocomial droplet transmission of viruses. [ABSTRACT FROM AUTHOR]

A three‐band tunable polarization‐insensitive metamaterial absorber is proposed in this paper. The unit cell of the absorber is composed of a dielectric substrate, a metal patch, and four varactor diodes welded on the top layer. A simple metal via bias network is designed to facilitate the absorption frequency tuning of the absorber. The simulation results show that when there is no bias voltage (0 V), the proposed absorber has three absorption peaks of 88%, 99.5%, and 99.8% under normal incidence at 7.27, 10.93, and 15.84 GHz, respectively. Furthermore, by adjusting the reverse bias voltage (0–19 V) of the varactor, the first absorption peak of the absorber can be tuned from 7.27 to 8.2 GHz and the second absorption peak tuned from 10.93 to 11.4 GHz. Meanwhile, the tuning range for the third absorption peak is 15.84–16.1 GHz. Furthermore, the three‐band absorption and frequency tunable characteristics of the absorber are confirmed by experimental tests. [ABSTRACT FROM AUTHOR]

Singlet microscopy is very attractive for the development of cost-effective and portable microscopes. In contrast to conventional microscope objectives, which consist of multiple lenses, the manufacturing process for singlet lenses is done without extensive assembling and aligning. In this manuscript, we report a novel singlet virtual Zernike phase contrast microscopy setup for unstained pathological tumor tissue slides. In this setup, the objective consists of only one lens. There is no need for the inset Zernike phase plate, which is even more expensive than a whole brightfield microscopy setup. The Zernike phase contrast is virtually achieved by the deep learning computational imaging method. For the practical virtual Zernike phase contrast microscopy setup, the computational time is less than 100 ms, which is far less than that of other computational quantitative phase imaging algorithms. With a conceptual demo experimental setup, we proved our proposed method to be competitive with a research-level conventional Zernike phase contrast microscope and effective for the unstained transparent pathological tumor tissue slides. It is believed that our deep learning singlet virtual phase contrast microscopy is potential for the development of low-cost and portable microscopes and benefits resource-limited areas. [ABSTRACT FROM AUTHOR]

Aims To examine the relationship between prenatal alcohol exposure (PAE) and children's behavioural and emotional development in a large generalizable sample of women and their children in Aotearoa New Zealand. Methods Using data from the Growing Up in New Zealand longitudinal cohort, we investigated the relationship between maternal PAE and behavioural and emotional development in 8-year-old children. We explored secondary outcomes including measures of language, executive function, academic achievement, and adaptive behaviour. Results We found no significant differences in the measures of behavioural and emotional development in children 8 years old based on alcohol consumption. No significant differences in behavioural and emotional development were found based on amount of PAE and when PAE occurred, despite controlling for a range of potential confounding factors, such as neighbourhood deprivation and maternal health measures. PAE was associated with significantly higher scores for parent-rated oral language indicating better oral language. In Māori mothers, PAE was significantly associated with an increased risk of higher scores on two of the Strengths and Difficulties Questionnaire subscales. Conclusions We did not find an association between PAE and behavioural and emotional development in children aged 8 years. PAE and behavioural and emotional development are difficult to measure accurately, and the moderating variables between them are complex. Future analyses will require larger cohorts of mothers and their children using precise measures of PAE and outcomes to enable more precise estimates of association. [ABSTRACT FROM AUTHOR]

Based on graphene metasurface, this paper proposes a broadband multifunctional reflective polarization converter in the terahertz regime. This converter was formed of periodic unit cells, and each cell comprises two gold resonant ribbons, two-layer graphene sheets, a dielectric spacer, and a ground plane. The results demonstrated that the converter presented dynamical multiple polarization-manipulating functions, such as linear-to-circular conversion and linear-to-linear conversion, by varying the Fermi energy of the graphene. For example, in the frequency range from 0.92 to 1.47 THz, the ultra-broadband cross-polarization conversion was obtained with a Fermi energy of 0 eV, and in the range from 0.55 to 1.26 THz, the ultra-broadband linear-to-circular polarization conversion was achieved by varying the Fermi energy with a tunable relative bandwidth of 78.5%. Finally, the physical mechanisms were determined by analyzing the equivalent circuits and current distributions. This polarization converter has the potential for future applications in electronic measurements, photonic design, and other optoelectronic systems. [ABSTRACT FROM AUTHOR]

Background: The American Joint Committee on Cancer (AJCC) staging system has been the standardized staging system for malignancies since the first edition in 1987. The 8th edition of gastric cancer was released in 2016, and is expected to be used in clinical practice in 2018. The aim of this study was to improve this new gastric cancer staging system. Methods: We conducted median overall survival analyses in a cohort of 8359 gastric cancer patients from the Surveillance, Epidemiology, and End Results (SEER) database (2004–2014) via Kaplan–Meier curves and log-rank tests, and proposed a modified staging system based on median OS. The concordance index (C-index) was conducted to evaluate the predictive accuracy. Results: Using the 8th AJCC staging system, the median OS of patients at the same stage varied widely between the different substages, especially in stage III. Despite the definitions of T, N, and M, substages in the modified staging system were regrouped based on median OS. The C-index of stage III patients with the modified staging system [0.579, 95% confidence interval (CI) 0.564–0.593] was higher than the 8th AJCC staging system (0.567, 95% CI 0.552–0.581). Moreover, we divided these patients into two groups according to their examined lymph node counts (≥15 or 1–14), and studied the effectiveness of the modified staging system in the two groups. Conclusions: The modified 8th AJCC staging system for gastric cancer proposed in this study generates better prognostic stratifications and may be evaluated for further update. AJCC American Joint Committee on Cancer OS Overall Survival SEER Surveillance, Epidemiology, and End Results [ABSTRACT FROM AUTHOR]

Metasurface, with the ultrathin thickness, has been extensively investigated in the past few years. A specific branch, the metasurface-based absorber, has generated considerable interest as a result of its high absorptivity of electromagnetic waves. In this paper, an ultra-wideband absorber based on patterned phosphorene metasurface is proposed in terahertz range and can overstep the bandwidth limitation of the conventional metasurface-based absorber. This absorber comprises 4-group phosphorene/dielectric pairs with various widths and regular spaces, which forms frustum pyramid stack on a gold ground. In this design, the surface plasmonic waves are excited on phosphorene and the wide bandwidth from 3.4 to 9.6 THz with the absorptivity ≥90% is obtained. Attributing to the electric dipolar resonance, the incident plane waves with various frequencies are absorbed at phosphorene with corresponding widths, which results in the ultra-wideband absorption. Moreover, it remains ultra-wideband and high absorption over a wide angular range of incidence around 40°, and an absorption band above 90% even for 70° incident angle. The proposed phosphorene-based absorber has potentials in THz detectors, thermal emitters, etc. [ABSTRACT FROM AUTHOR]

ABSTRACT: BACKGROUND: While dietary sources of calcium are important for bone health, the intake of milk and milk products decreases as children get older. A free milk in schools program may mitigate this decrease in milk consumption. We evaluated the Fonterra Milk for schools program (a free milk initiative) by determining changes in children's milk consumption and anthropometric measures over a 2‐year period. METHODS: The evaluation was conducted in children aged 7‐9 years in a representative sample of primary schools participating in the free milk program, in Auckland, New Zealand. The primary outcome was the proportion of children meeting the New Zealand guidelines for dairy and milk product consumption over 7 days (≥2 servings per day). Changes in anthropometric measures were also assessed as secondary outcomes. RESULTS: Nine schools (N = 511 children) participated in the evaluation. The proportion of children meeting the New Zealand guidelines for milk and milk product consumption over 7 days increased significantly from baseline to 2 years' follow‐up (72% vs 94%; p < .001). Body mass index z scores did not change significantly between baseline and 2 years' follow‐up. CONCLUSIONS: The Fonterra Milk for Schools initiative appears to be an effective way of increasing milk/milk product consumption behaviors in school‐aged children. [ABSTRACT FROM AUTHOR]

Aims: To examine the frequency of promotions on breakfast cereals and drinks in a major New Zealand supermarket chain, determine the healthiness of promoted versus non‐promoted products, and quantify the effects of promotions on sales. Methods: Weekly data on product promotions and sales were collected in six Auckland supermarkets for 198 breakfast products over 12 weeks. The healthiness of products was determined using the Health Star Rating system, and the effect of promotions on sales was estimated using linear mixed models. Results: On average, 47% of breakfast products in a given week were promoted using on‐shelf tickets, 12% in weekly mailers, and 9% via promotional displays. The healthiness of promoted and non‐promoted breakfast products was comparable. In relation to weekly sales of non‐promoted products, all three promotional strategies had substantial (2 to 2.5 times higher sales) and statistically significant (P < 0.001) effects on product sales. Conclusion: Promotions are frequently used and effective at increasing sales. Marketing strategies focusing solely on promoting healthier products could be an important nudging strategy to improve the healthiness of supermarket food purchases. [ABSTRACT FROM AUTHOR]

In this paper, a four-direction anomalous reflection metasurface is proposed. The basic cells comprise of squares and circles, which are designed at various sizes and arranged in a super cell at regular spacing. Then, properly combining super cells molds a square phase gradient metasurface (PGM). It is mounted on an optical thickness gold mirror, which inhibits all light transmission. Markedly different from previously reported metasurfaces, the square PGM is characterized by four-direction reflection beams. It takes into consideration the normal incidence and the oblique incidence. For the normal incidence, that the degrees of the four reflection angles are identical is due to the x , − x , y and − y directional discontinuous phase gradients, and lies on the symmetric structure in the x o y plane, which is then revealed by the surface current distribution. Incident angles varying from −20° to 20°, the reflection angles are demonstrated in the oblique incidence. Moreover, the PGM is polarization-independent. The performance is attributed to the symmetry of structure, which is verified by Radar cross section. Simulated results prove that our method offers a simple and effective strategy for metasurface design in terahertz. The proposed PGM can aid in focused beams, steering beams, and shaped beams. [ABSTRACT FROM AUTHOR]

With meta-analysis, participant-level data from five text messaging-based smoking cessation intervention studies were pooled to investigate cessation patterns across studies and participants. Individual participant data (N=8315) collected in New Zealand (2001-2003; n=1705), U.K. (2008-2009; n=5792), U.S. (2012; n=503; n=164) and Turkey (2012; n=151) were collectively analyzed in 2014. The primary outcome was self-reported 7-day continuous abstinence at 4weeks post-quit day. Secondary outcomes were: (1) self-reported 7-day continuous abstinence at 3months and (2) self-reported continuous abstinence at 6months post-quit day. Generalized linear mixed models were fit to estimate the overall treatment effect, while accounting for clustering within individual studies. Estimates were adjusted for age, sex, socioeconomic status, previous quit attempts, and baseline Fagerstrom score. Analyses were intention to treat. Participants lost to follow-up were treated as smokers. Twenty-nine percent of intervention participants and 12% of control participants quit smoking at 4weeks (adjusted odds ratio [aOR]=2.89, 95% CI [2.57, 3.26], p<.0001). An attenuated but significant effect for cessation for those in the intervention versus control groups was observed at 3months (aOR=1.88, 95% CI [1.53, 2.31]) and 6months (aOR=2.24, 95% CI [1.90, 2.64]). Subgroup analyses were conducted but few significant findings were noted. Text messaging-based smoking cessation programs increase self-reported quitting rates across a diversity of countries and cultures. Efforts to expand these low-cost and scalable programs, along with ongoing evaluation, appear warranted. [ABSTRACT FROM AUTHOR]

• An improved PIE based on computational deep learning color-transferring method is proposed for achieving colorful large FOV lens-less microscopy imaging. • The image data are three times less than those images under multiple illuminations for colorful PIE microscopy. • The color reconstructing time is very short, i.e., ∼7 ms. • The reconstructed color is very close to the 'true data', where is 2.7105. The ptychographic iterative engine (PIE) is an algorithm for coherent lens-less diffraction imaging. It facilitates the development of low-cost large field of view (FOV) lens-less microscopy, as it can expand the FOV extensively by moving the light source or the bio-medical pathological sample slide. In a PIE setup, the illumination light needs to have high/partially coherence. Thus, to get a colorful microscopy image, more than 3 illumination light sources with different dominant wavelengths are required in a traditional PIE setup. In this manuscript, an improved PIE based on computational deep learning color-transferring method is proposed to achieve colorful large FOV lens-less microscopy imaging. In our method, only one high/partially coherent light source is used, where the image data are three times less than those images under multiple illuminations for colorful PIE microscopy. It is believable that our colorful PIE microscopy enhanced by the deep color-transferring method would be helpful for the development of low-cost large FOV lens-less microscopes. [ABSTRACT FROM AUTHOR]

Background: A healthy lifestyle program that appeals to, and supports, overweight and obese New Zealand (NZ) European, Māori (indigenous) and Pasifika men to achieve weight loss is urgently needed. A pilot program inspired by the successful Football Fans in Training program but delivered via professional rugby clubs in NZ (n = 96) was shown to be effective in weight loss, adherence to healthy lifestyle behaviors, and cardiorespiratory fitness in overweight and obese men. A full effectiveness trial is now needed. Aims: To determine the effectiveness and cost effectiveness of Rugby Fans In Training-NZ (RUFIT-NZ) on weight loss, fitness, blood pressure, lifestyle change, and health related quality of life (HRQoL) at 12- and 52-weeks. Methods: We conducted a pragmatic, two-arm, multi-center, randomized controlled trial in NZ with 378 (target 308) overweight and obese men aged 30–65 years, randomized to an intervention group or wait-list control group. The 12-week RUFIT-NZ program was a gender-sensitised, healthy lifestyle intervention delivered through professional rugby clubs. Each intervention session included: i) a 1-h workshop-based education component focused on nutrition, physical activity, sleep, sedentary behavior, and learning evidence-based behavior change strategies for sustaining a healthier lifestyle; and 2) a 1-h group-based, but individually tailored, exercise training session. The control group were offered RUFIT-NZ after 52-weeks. The primary outcome was change in body weight from baseline to 52-weeks. Secondary outcomes included change in body weight at 12-weeks, waist circumference, blood pressure, fitness (cardiorespiratory and musculoskeletal), lifestyle behaviors (leisure-time physical activity, sleep, smoking status, and alcohol and dietary quality), and health-related quality of life at 12- and 52-weeks. Results: Our final analysis included 200 participants (intervention n = 103; control n = 97) who were able to complete the RUFIT-NZ intervention prior to COVID-19 restrictions. At 52-weeks, the adjusted mean group difference in weight change (primary outcome) was -2.77 kg (95% CI -4.92 to -0.61), which favored the intervention group. The intervention also resulted in favorable significant differences in weight change and fruit and vegetable consumption at 12-weeks; and waist circumference, fitness outcomes, physical activity levels, and health-related quality of life at both 12 and 52 weeks. No significant intervention effects were observed for blood pressure, or sleep. Incremental cost-effective ratios estimated were $259 per kg lost, or $40,269 per quality adjusted life year (QALY) gained. Conclusion: RUFIT-NZ resulted in sustained positive changes in weight, waist circumference, physical fitness, self-reported physical activity, selected dietary outcomes, and health-related quality of life in overweight/obese men. As such, the program should be recommended for sustained delivery beyond this trial, involving other rugby clubs across NZ. Trial registration: Australia New Zealand Clinical Trials Registry, ACTRN12619000069156. Registered 18 January 2019, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376740 Universal Trial Number, U1111-1245–0645. [ABSTRACT FROM AUTHOR]

Summary In this paper we discuss the analysis of data from population-based case-control studies when there is appreciable non-response. We develop a class of estimating equations that are relatively easy to implement. For some important special cases, we also provide efficient semi-parametric maximum-likelihood methods. We compare the methods in a simulation study based on data from the Women's Cardiovascular Health Study discussed in Arbogast et al. (Estimating incidence rates from population-based case-control studies in the presence of non-respondents, Biometrical Journal 44, 227-239, 2002). [ABSTRACT FROM AUTHOR]

Abstract: Electronic supermarket sales data provide a promising, novel way of estimating nutrient intakes. However, little is known about how these data reflect the nutrients consumed by an individual household member. A cross-sectional survey of 49 primary household shoppers (age [mean±standard deviation age]=48±14 years; 84% female) from Wellington, New Zealand, was undertaken. Three months of baseline electronic supermarket sales data were compared with individual dietary intakes estimated from four random 24-hour dietary recalls collected during the same 3-month period. Spearman rank correlations between household purchases and individual intakes ranged from 0.54 for percentage of energy from saturated fat (P<0.001) to 0.06 for sodium (P=0.68). Other correlation coefficients were: percentage of energy from carbohydrate, 0.48; and protein, 0.44; energy density of nonbeverages, 0.37 (kcal/oz); percentage of energy from total fat, 0.34; sugar, 0.33 (oz/kcal); and energy density of beverages, 0.09 (oz/kcal; all P values <0.05). This research suggests that household electronic supermarket sales data may be a useful surrogate measure of some nutrient intakes of individuals, particularly percentage of energy from saturated and total fat. In the case of a supermarket intervention, an effect on household sales of percentage energy from saturated and total fat is also likely to impact the saturated and total fat intake of individual household members. [Copyright &y& Elsevier]

It is not uncommon for a continuous outcome variable Y to be dichotomized and analysed using logistic regression. Moser and Coombs ( Statist. Med. 2004; 23:1843-1860) provide a method for converting the output from a standard linear regression analysis using the original continuous outcome Y to give much more efficient inferences about the same odds-ratio parameters being estimated by the logistic regression. However, these results apply only to prospective studies. This paper follows up Moser and Coombs by providing an efficient linear-model-based solution for data collected using case-control studies. Gains in statistical efficiency of up to 240 per cent are obtained even with small to moderate odds ratios. Differences in design efficiency between case-control and prospective sampling designs are found to be much smaller, however, when linear-model-based analyses are being used than they are when logistic regression analyses are being used. Copyright © 2008 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

We extend the discussion of Lee et al. ( Stat. Med. 1997; 16:1377-1389) and others on methods for performing secondary analyses of case-control sampled data and carry out an extensive investigation of efficiency and robustness. We find that, with the exception of the 'analyse-the-controls-only' strategy for populations in which cases are rare, ad hoc methods in common usage often lead to extremely misleading conclusions and that it is not possible to tell in advance when this will happen. Weighted likelihood and semi-parametric maximum likelihood methods are justified theoretically. We find that semi-parametric maximum likelihood can be as much as twice as efficient as the weighted method, but is subject to bias in estimating parameters of interest when the nuisance models this method requires have been misspecified. The weighted method needs no nuisance models and thus is robust in this regard, but we cannot tell when it is going to be very inefficient without sophisticated modelling as through the SPML method. Practitioners should routinely use both methods and will often have to weigh up the practical consequences of severe inefficiency and lack of robustness in the context of their enquiries. Copyright © 2005 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

• A portable singlet phase contrast microscope based on smart-phones are proposed. • Our designed aspheric singlet lens keeps the same MTF curves across all FOVs. • The picture is virtually enhanced to a phase contrast image by deep learning. • There is no inset Zernike phase plate. Amounts of cost-effective biological observing and detecting instruments are needed in biology and medical applications. In these demands, a low-cost, portable microscope with light-weight and tele-communication, is very attractive in the resource-limit area. In this manuscript, a portable singlet phase contrast microscope based on smart-phones are proposed. In the optics hardware, an external singlet lens is designed and closely attached before the rear cameras of a smart-phone, which constructs the imaging part of a simplified microscope. And a circular oblique illumination is adopted. In the computational imaging part, the in-focus images recorded by the smart-phone are virtually enhanced and style-transferred to phase contrast images by deep learning methods. Through pairs of experimental image data, we train the deep learning network and demonstrate the effectiveness of this virtual phase contrast imaging approach using multiple samples, e.g., unstained/transparent tumor tissue pathological slide, and H&E (Hematoxylin and Eosin) stained tumor tissue pathological slide. Our results provide a powerful example of low-cost portable phase contrast microscope with high-speed tele-communication abilities in the 5G + mobile internet era. [ABSTRACT FROM AUTHOR]

We propose a hybrid plasmonic waveguide (HPW) base on Bulk-Dirac-semimetal (BDS). By inserting the dual-ridge (DR) structure into the low-index gap of the conventional HPW, the terahertz wave can be confined efficiently and then a small mode area can be brought. Based on the finite element method (FEM), the results of the proposed DR HPW are compared with that of the single-ridge hybrid plasmonic waveguide (SR HPW), which show the advanced performance of the proposed design. Besides, the BDS plasmon particularly differs from plasmon of metal in that the propagation loss can be tuned by adjusting the Fermi energy level. With a reasonable Fermi energy level, over 10 times improvement of the Figure of merit (FoM) can be obtained. • A hybrid plasmonic waveguide (HPW) with dual-ridge (DR) structure base on Bulk-Dirac-semimetal (BDS) is proposed. • Small mode area and large propagation length are realized. • Compared with single-ridge HPW, the DRHPW exhibits a better performance. • Performance of the waveguide can be significantly improved by adjusting the Fermi energy level (E F) of BDS. [ABSTRACT FROM AUTHOR]

Adjuvants to compression are sought for treating venous ulceration. There is animal, observational and trial evidence that suggests statins increase venous ulcer healing. The objective of this study was to conduct secondary analyses investigating the association of statin use with healing in three randomised trials that recruited people with venous ulceration. The difference in healing rates was modest but higher in the statins group. Crude analyses found no significant difference between the groups, but when adjusted for the trial effect and potential confounders (age, diabetes, first ever ulcer, ulcer area and ulcer duration), significantly more participants healed among those taking statins. The analyses were robust to method of analysis (fixed effects or random effects models). A definitive trial is required to evaluate the effect of statins versus placebo on venous ulcer healing, but until then patients needing to take statins seem unlikely to be disadvantaged by this treatment. [ABSTRACT FROM AUTHOR]

Objective: There is increasing evidence that EDs may not operate equitably for all patients, with Indigenous and minoritised ethnicity patients experiencing longer wait times for assessment, differential pain management and less evaluation and treatment of acute conditions. Methods: This retrospective observational study used a Kaupapa Māori framework to investigate ED admissions into 18/20 District Health Boards in Aotearoa New Zealand (2006–2012). Key pre‐admission variable was ethnicity (Māori:non‐Māori), and outcome variables included: ED self‐discharge; ED arrival to assessment time; hospital re‐admission within 72 h; ED re‐presentation within 72 h; ED length of stay; ward length of stay; access block and mortality (in ED or within 10 days of ED departure). Generalised linear regression models controlled for year of presentation, sex, age, deprivation, triage category and comorbidity. Results: Despite some ED process measures favouring Māori, for example arrival to assessment time (mean difference −2.14 min; 95% confidence interval [CI] −2.42 to −1.86) and access block (odds ratio [OR] 0.89, 95% CI 0.87–0.91), others showed no difference, for example self‐discharge (OR 0.98, 95% CI 0.97–1.00). Despite this, Māori mortality (OR 1.60, 95% CI 1.50–1.71) and ED re‐presentation (OR 1.11, 95% CI 1.09–1.12) were higher than non‐Māori. Conclusion: To our knowledge, this is the most comprehensive investigation of acute outcomes by ethnicity to date in New Zealand. We found ED mortality inequities that are unlikely to be explained by ED process measures or comorbidities. Our findings reinforce the need to investigate health professional bias and institutional racism within an acute care context. [ABSTRACT FROM AUTHOR]

Purpose: There is uncertainty about the effect of increased neonatal protein intake on neurodevelopmental outcomes following preterm birth. The aim of this study was to assess the effect of a change in neonatal nutrition protocol at a major tertiary neonatal intensive care unit intended to increase protein intake on ophthalmic and visual development in school‐age children born very preterm. Methods: The study cohort comprised children (n = 128) with birthweight <1500 g or gestational age < 30 weeks born at Auckland City Hospital before (OldPro group, n = 55) and after (NewPro group, n = 73) a reformulation of parenteral nutrition that resulted in increased total protein intake during the first postnatal week and decreased carbohydrate, total parenteral fluid and sodium intake. Clinical and psychophysical vision assessments were completed at 7 years' corrected age, including visual acuity, global motion perception (a measure of dorsal stream function), stereoacuity, ocular motility and ocular health. Composite measures of favourable overall visual, binocular and functional visual outcomes along with individual vision measures were compared between the groups using logistic and linear regression models. Results: Favourable overall visual outcome did not differ between the two groups. However, global motion perception was better in the NewPro group (p = 0.04), whereas the OldPro group were more likely to have favourable binocular visual outcomes (60% vs. 36%, p = 0.02) and passing stereoacuity (p = 0.02). Conclusions: These results indicate subtle but complex associations between early neonatal nutrition after very preterm birth and visual development at school age. [ABSTRACT FROM AUTHOR]

Introduction: The burden of stroke in patients with hypertension is very high, and its prediction is critical. Objectives: We aimed to use plasma lipidomics profiling to identify lipid biomarkers for predicting incident stroke in patients with hypertension. Methods: This was a nested case-control study. Baseline plasma samples were collected from 30 hypertensive patients with newly developed stroke, 30 matched patients with hypertension, 30 matched patients at high risk of stroke, and 30 matched healthy controls. Lipidomics analysis was performed by ultrahigh-performance liquid chromatography–tandem mass spectrometry, and differential lipid metabolites were screened using multivariate and univariate statistical methods. Machine learning methods (least absolute shrinkage and selection operator, random forest) were used to identify candidate biomarkers for predicting stroke in patients with hypertension. Results: Co-expression network analysis revealed that the key molecular alterations of the lipid network in stroke implicate glycerophospholipid metabolism and choline metabolism. Six lipid metabolites were identified as candidate biomarkers by multivariate statistical and machine learning methods, namely phosphatidyl choline(40:3p)(rep), cholesteryl ester(20:5), monoglyceride(29:5), triglyceride(18:0p/18:1/18:1), triglyceride(18:1/18:2/21:0) and coenzyme(q9). The combination of these six lipid biomarkers exhibited good diagnostic and predictive ability, as it could indicate a risk of stroke at an early stage in patients with hypertension (area under the curve = 0.870; 95% confidence interval: 0.783–0.957). Conclusions: We determined lipidomic signatures associated with future stroke development and identified new lipid biomarkers for predicting stroke in patients with hypertension. The biomarkers have translational potential and thus may serve as blood-based biomarkers for predicting hypertensive stroke. [ABSTRACT FROM AUTHOR]

Background: International guidelines recommend early discharge for uncomplicated acute coronary syndrome (ACS) patients within 3 days; however, there is a paucity of contemporary literature regarding the safety of this strategy. Aims: To report the trends in the proportion of ACS hospitalisations discharged within 3 days and their outcomes in New Zealand. Methods: ACS hospitalisations 2006–2015 using national routinely collected data were categorised by length of stay (LOS) into ≤3, 4–5 and >5 days, excluding deaths during the index admission. Trend analysis of death, cardiovascular and bleeding events and their composites (net adverse clinical events) at 30‐day and 1‐year post‐discharge were performed using generalised linear mixed regression models adjusting for covariates by LOS subgroups. Results: Among 130 037 ACS hospitalisations, LOS ≤ 3 days increased from 32% in 2006 to 44% in 2016. This trend was observed for all demographics, ACS subtypes and management strategies. Event rates at 30 days and 1 year were the lowest for the LOS ≤3 days subgroup (all‐cause mortality 1.6% and 9.1% respectively). Thirty‐day and 1‐year all‐cause mortality rates were unchanged over time for this subgroup (adjusted odds ratio (95% confidence interval) of 1.011 (0.985–1.038) and 0.991 (0.979–1.003)), while net adverse clinical event rates significantly decreased (0.962 (0.950–0.973) and 0.972 (0.964–0.980) respectively). Conclusion: There was a substantial increase in early discharge post‐ACS over 10 years. These patients were associated with reduction in adverse clinical events up to 1 year and no increase in all‐cause mortality. These findings from a comprehensive national register suggest that guideline recommendations on early discharge after uncomplicated ACS are safe and appropriate. [ABSTRACT FROM AUTHOR]

Ischemic stroke (IS) is the most common type of stroke and is characterized by high rates of mortality and long-term injury. The prediction and early diagnosis of IS are therefore crucial for optimal clinical intervention. Proteomics has provided important techniques for exploring protein markers associated with IS, but there has been no systematic evaluation and review of research that has used these techniques. Here, we review the differential proteins that have been found in cell- and animal- based studies and clinical trials of IS in the past 10 years; determine the key pathological proteins that have been identified in clinical trials; summarize the target proteins affected by interventions aimed at treating IS, with a focus on traditional Chinese medicine treatments. Overall, we clarify findings and problems that have been identified in recent proteomics research on IS and provide suggestions for improvements in this area. We also suggest areas that could be explored for determining the pathogenesis and developing interventions for IS. [ABSTRACT FROM AUTHOR]

Objective: Internationally, Indigenous and minoritised ethnic groups experience longer wait times, differential pain management and less evaluation and treatment for acute conditions within emergency medicine care. Examining ED Inequities (EEDI) aims to investigate whether inequities between Māori and non‐Māori exist within EDs in Aotearoa New Zealand (NZ). This article presents the descriptive findings for the present study. Methods: A retrospective observational study framed from a Kaupapa Māori positioning, EEDI uses secondary data from emergency medicine admissions into 18/20 District Health Boards in NZ between 2006 and 2012. Data sources include variables from the Shorter Stays in ED National Research Project database and comorbidity data from NZ's National Minimum Dataset. The key predictor of interest is patient ethnicity with descriptive variables, including sex, age group, area deprivation, mode of presentation, referral method, Australasian Triage Scale and trauma status. Results: There were a total of 5 972 102 ED events (1 168 944 Māori, 4 803 158 non‐Māori). We found an increasing proportion of ED events per year, with a higher proportion of Māori from younger age groups and areas of high deprivation compared to non‐Māori events. Māori also had a higher proportion of self‐referral and were triaged to be seen within a longer time frame compared to non‐Māori. Conclusion: Our findings show that there are different patterns of ED usage when comparing Māori and non‐Māori events. The next level of analysis of the EEDI dataset will be to examine whether there are any associations between ethnicity and ED outcomes for Māori and non‐Māori patients. Examining ED Inequities aims to investigate whether inequities between Māori and non‐Māori exist within EDs in Aotearoa New Zealand. This article presents the descriptive findings for this study. Our findings show that there are different patterns of ED usage when comparing Māori and non‐Māori events. [ABSTRACT FROM AUTHOR]

A narrow‐band bandpass filter (BPF) based on parallel coupled lines and shorted stubs with very wide upper stopband has been presented. The transmission coefficient and reflection coefficient of the proposed BPF are straightforwardly derived via the input impedances using odd‐ and even‐mode analysis method. The calculation results illustrate that two narrow passbands with very high frequency ratio of the upper‐band to lower‐band center frequencies can be realized, which is significantly suitable to design a narrow‐band BPF with very wide upper stopband. To verify the proposed design idea, a narrow‐band BPF example was designed and experimentally characterized, whose measured in‐band return loss is >30 dB with center frequency at 1.76 GHz. The measured upper stopband is up to 14.34 GHz with the rejection levels of over 20 dB. [ABSTRACT FROM AUTHOR]

Background: The nutritional composition of foods and beverages consumed away from the home has important implications for population health. Our objective was to determine if the serve size, energy, and sodium contents of fast foods sold at chain restaurants in New Zealand (NZ) changed between 2012 and 2016.Methods: Serve size and nutrient data were collected in annual cross-sectional surveys of all products sold at 10 major fast food chains. Changes over time may occur due to alterations in product availability or individual product reformulation. Linear regression adjusting for food group and chain was used to estimate overall changes in serve size and nutrients. Random effects mixed models were used to estimate reformulation changes on same products available for two or more years.Results: Across all products (n = 5468) increases were observed in mean serve size (+ 9 (3, 15) g, + 5%), energy density (+ 54 (27, 81) kJ/100 g, + 6%), energy per serve (+ 178 (125, 231) kJ, + 14%), and sodium per serve (+ 55 (24, 87) mg, + 12%). Sodium density did not change significantly. Four of 12 food groups (Desserts, Pizza, Sandwiches, and Salads) and four of 10 fast food chains (Domino's, Hell Pizza, Pizza Hut, and Subway) displayed large, undesirable changes for three or more (of five) outcomes (≥10%; p < 0.05). One food group (Asian) and one chain (St Pierre's) displayed large, desirable changes for two or more outcomes. The only significant reformulation change was a drop in sodium density (- 22 (- 36, - 8) mg/100 g, - 7%).Conclusions: The serve size and energy density of NZ fast food products has increased significantly over the past 5 years. Lower sodium concentration in new and reformulated products has been offset by overall increases in serve size. Continued monitoring and development and implementation of Government-led targets for serve size and nutrient content of new and existing fast food products are required. [ABSTRACT FROM AUTHOR]

Background: Evaluating trends in acute coronary syndrome (ACS) and invasive coronary procedures, including coronary angiography, percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) can identify areas for improvement in clinical care and inform future health planning. This national data-linkage study reports trends in ACS hospitalisations and procedure rates in New Zealand between 2006 and 2016.Methods: All adult ACS hospitalisations and associated angiography and revascularisation procedures were identified from hospital discharge codes. Crude and age-standardised ACS incidence and procedure rates were calculated for each calendar year.Results: Between 2006 and 2016 there were 188,264 ACS admissions. During this time, there was a steady decline in hospitalisation rates, from 685 to 424 per 100,000 per year. This decline was observed in both sexes and in all age groups. There were also significant increases in coronary angiography and revascularisation rates, from 29.8% to 54.3% and 20.6% to 37.3%, respectively, between 2006 and 2016. The rate of revascularisation by PCI increased from 16.0% to 31.0%, a greater increase than revascularisation by CABG, which increased from 4.6% to 6.5%. Increases in procedures were observed in all age groups and both sexes. The proportions of coronary angiograms that resulted in revascularisation each year consistently ranged from 67 to 70% throughout the period.Conclusions: Acute coronary syndrome hospitalisation rates in New Zealand decreased by nearly 40% between 2006 and 2016, while the use of coronary angiography and revascularisation after ACS nearly doubled. The similar proportions of angiograms that resulted in revascularisation each year suggests that, despite the doubling of angiograms over the 10-year study period, they are not over-utilised. [ABSTRACT FROM AUTHOR]

Background: A healthy lifestyle program that appeals to, and supports, obese New Zealand (NZ) European, Māori (indigenous) and Pasifika men to achieve weight loss is urgently needed. In Scotland, Football Fans in Training (FFIT), a weight management and healthy lifestyle program for overweight and obese men aged 35-65 years , delivered by community coaching staff at professional football clubs, has been shown to be beneficial and cost-effective. A pilot program inspired by FFIT but delivered by professional rugby clubs in NZ (n = 96) was shown to be effective in weight loss, improved physiological outcomes, and adherence to healthy lifestyle behaviors in overweight and obese men. The objective of this trial is to determine the effectiveness and cost-effectiveness of the Rugby Fans in Training New Zealand (RUFIT-NZ) program.Methods: A pragmatic, two-arm, multi-center, randomized controlled trial involving 308 overweight and obese men aged 30-65 years, randomized to either an intervention group (n = 154) or a wait-list control group (n = 154). The intervention-group participated in the 12-week RUFIT-NZ program, a gender-sensitized, healthy lifestyle intervention adapted to the environment and cultural diversity of NZ and delivered through professional rugby clubs. Participants in the intervention group undergo physical training sessions, in addition to workshop-based sessions to learn about nutrition, physical activity, sleep, sedentary behavior, and a range of behavior-change strategies for sustaining a healthier lifestyle. The control group receives the program after 52 weeks. The primary outcome is change in body weight from baseline to 52 weeks. Secondary outcomes include change in body weight at 12 weeks; waist circumference, blood pressure, fitness, and lifestyle behaviors at 12 and 52 weeks; and cost-effectiveness. A process evaluation informed by the RE-AIM framework will evaluate potential implementation of RUFIT-NZ as an ongoing program in NZ after the trial.Discussion: This trial will investigate the effectiveness and cost-effectiveness of the RUFIT-NZ program in overweight and obese NZ men.Trial Registration: Australia New Zealand Clinical Trials Registry, ACTRN12619000069156. Registered on 18 January 2019, according to the World Health Organization Trial Registration Data Set. Universal Trial Number, U1111-1245-0645. [ABSTRACT FROM AUTHOR]

Objectives: Ethnic inequities in health outcomes have been well documented with Indigenous peoples experiencing a high level of healthcare need, yet low access to, and through, high‐quality healthcare services. Despite Māori having a high ED use, few studies have explored the potential for ethnic inequities in emergency care within New Zealand (NZ). Healthcare delivery within an ED context is characterised by time‐pressured, relatively brief, complex and demanding environments. When clinical decision‐making occurs in this context, provider prejudice, stereotyping and bias are more likely. The examining emergency department inequities (EEDI) research project aims to investigate whether clinically important ethnic inequities between Māori and non‐Māori exist. Methods: EEDI is a retrospective observational study examining ED admissions in NZ between 2006 and 2012 (5 976 126 ED events). EEDI has been designed from a Kaupapa Māori Research position. Results: The primary data source is the existing Shorter Stays in Emergency Department National Research Project (SSED) dataset that will be combined with clinical information extracted from NZ's National Minimum Dataset. The key predictor variable is patient ethnicity with other covariates including: sex, age‐group, area deprivation, mode of presentation, referral method, Australasian Triage Scale and the Multimorbidity Measure (M3 Index) for co‐morbidities. Generalised linear regression models will be used to investigate the associations between pre‐admission variables and the measures of ED care, and to examine the contribution of each measure of ED care on ethnic inequities in mortality. Conclusion: The present study will provide the largest, most comprehensive investigation of ED outcomes by ethnicity to date in NZ. [ABSTRACT FROM AUTHOR]

Chronic spontaneous urticaria (CSU) is a recurrent disease characterized by wheals and or angioedema, and its pathogenesis is still unclear. The microarray datasets of skin tissue from CSU patients and healthy controls were integrated and analysed in Gene Expression Omnibus (GEO). Differentially expressed genes (DEGs) were identified using the NetworkAnalyst tool. Then, the Gene Ontology (GO) and Kyoto Encyclopaedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed. Subsequently, a protein–protein interaction (PPI) network of DEGs was constructed by STRING and the related hub genes were identified through the MOCDE tool. The potential miRNAs targeting hub genes were predicted based on the intersection of three online databases, namely TargetScanHuman, TargetBase and miRNet. Differentially expressed lncRNAs (DElncRNAs) was performed using the GEO2R tool. The potential miRNAs targeting DElncRNAs were predicted through miRNet. Finally, the shared miRNAs targeting both hub genes and DElncRNAs were used to construct an mRNA/miRNA/lncRNA regulatory network. A total of 296 DEGs were obtained, which were mainly enriched in inflammatory and immune responses. Further, 14 hub genes were identified by the PPI network of DEGs. Clinical correlation analysis showed that the mRNA expressions of S100A7, S100A8, S100A9, S100A12, IL6 and SOCS3 in CSU were positively correlated with the 7‐day urticaria activity score (UAS7), and their potential diagnostic value was supported by the receiver operating characteristic curve (ROC) analysis. Five up‐regulated lncRNAs in the cytoplasm were obtained by DElncRNAs analysis. The ROC analysis showed that PVT1, SNHG3 and ZBTB20 − AS1 was of potential diagnostic value for CSU. Eight shared miRNAs targeting both hub genes and DElncRNAs were identified and used to construct a competing endogenous RNA (ceRNA) network. It was found that the IL‐6/miR − 149 − 5p/ZBTB20 − AS1 axis might play an important role in the activation of mast cells in CSU. IL‐6 and its related regulatory molecules may be used as potential diagnostic markers and therapeutic targets for CSU. [ABSTRACT FROM AUTHOR]

Background: Physical activity is a modifiable behavior related to many preventable non-communicable diseases. There is an age-related decline in physical activity levels in young people, which tracks into adulthood. Common interactive technologies such as smartphones, particularly employing immersive features, may enhance the appeal and delivery of interventions to increase levels of physical activity in young people. The primary aim of the Apps for IMproving FITness (AIMFIT) trial is to evaluate the effectiveness of two popular "off-the-shelf" smartphone apps for improving cardiorespiratory fitness in young people. Methods/design: A three-arm, parallel, randomized controlled trial will be conducted in Auckland, New Zealand. Fifty-one eligible young people aged 14-17 years will be randomized to one of three conditions: 1) use of an immersive smartphone app, 2) use of a non-immersive app, or 3) usual behavior (control). Both smartphone apps consist of an eight-week training program designed to improve fitness and ability to run 5 km, however, the immersive app features a game-themed design and adds a narrative. Data are collected at baseline and 8 weeks. The primary outcome is cardiorespiratory fitness, assessed as time to complete the one mile run/walk test at 8 weeks. Secondary outcomes are physical activity levels, self-efficacy, enjoyment, psychological need satisfaction, and acceptability and usability of the apps. Analysis using intention to treat principles will be performed using regression models. Discussion: Despite the proliferation of commercially available smartphone applications, there is a dearth of empirical evidence to support their effectiveness on the targeted health behavior. This pragmatic study will determine the effectiveness of two popular "off-the-shelf" apps as a stand-alone instrument for improving fitness and physical activity among young people. Adherence to app use will not be closely controlled; however, random allocation of participants, a heterogeneous group, and data analysis using intention to treat principles provide internal and external validity to the study. The primary outcome will be objectively assessed with a valid and reliable field-based test, as well as the secondary outcome of physical activity, via accelerometry. If effective, such applications could be used alongside existing interventions to promote fitness and physical activity in this population. Trial Registration: Australian New Zealand Clinical Trials Registry: ACTRN12613001030763. Registered 16 September 2013. [ABSTRACT FROM AUTHOR]

Background: There are few objective data on how nutrition labels are used in real-world shopping situations, or how they affect dietary choices and patterns.Design: The Starlight study was a four-week randomised, controlled trial of the effects of three different types of nutrition labels on consumer food purchases: Traffic Light Labels, Health Star Rating labels, or Nutrition Information Panels (control). Smartphone technology allowed participants to scan barcodes of packaged foods and receive randomly allocated labels on their phone screen, and to record their food purchases. The study app therefore provided objectively recorded data on label viewing behaviour and food purchases over a four-week period. A post-hoc analysis of trial data was undertaken to assess frequency of label use, label use by food group, and association between label use and the healthiness of packaged food products purchased.Results: Over the four-week intervention, study participants (n = 1255) viewed nutrition labels for and/or purchased 66,915 barcoded packaged products. Labels were viewed for 23% of all purchased products, with decreasing frequency over time. Shoppers were most likely to view labels for convenience foods, cereals, snack foods, bread and bakery products, and oils. They were least likely to view labels for sugar and honey products, eggs, fish, fruit and vegetables, and meat. Products for which participants viewed the label and subsequently purchased the product during the same shopping episode were significantly healthier than products where labels were viewed but the product was not subsequently purchased: mean difference in nutrient profile score -0.90 (95% CI -1.54 to -0.26).Conclusions: In a secondary analysis of a nutrition labelling intervention trial, there was a significant association between label use and the healthiness of products purchased. Nutrition label use may therefore lead to healthier food purchases. [ABSTRACT FROM AUTHOR]

Background We aimed to evaluate metabolic outcomes in overweight/obese nulliparous and multiparous women and their offspring. Study design Seventy-two overweight and obese women who participated in a randomized controlled trial of exercise in pregnancy were included in the study, comparing 18 nulliparous and 54 multiparous women and their singleton offspring. Women were assessed at 19 and 36 weeks of gestation. Fetal growth was measured using standard obstetric ultrasound techniques. Cord blood was collected at birth. Maternal and offspring body composition was assessed using DXA ~2 weeks after delivery. Results Nulliparous women had higher HbA1c in the third trimester of pregnancy than multiparous women (5.48% vs 5.29%; P=.002) and were more insulin-resistant based on the surrogate marker sex hormone-binding globulin (354 vs 408 nmol/L; P=.047). Nulliparous women also had higher levels of the inflammatory marker tumour necrosis factor-alpha (4.74 vs 3.62 pg/mL; P=.025). At birth, the offspring of nulliparous women were on average 340 g ( P=.013) and 0.69 standard deviation scores ( P=.026) lighter than those born of multiparous women. Cord blood data showed lower insulin-like growth factor- II ( P=.026) and higher IGF binding protein-1 ( P=.002) levels in the offspring of nulliparous women. In addition, a less favourable metabolic profile was observed in the offspring of nulliparous women, as indicated by higher triglyceride ( P<.001) and interleukin-6 ( P=.039) concentrations. Conclusions Infants born of nulliparous overweight and obese women appear to be exposed to a less favourable metabolic environment in utero, with evidence of subtle adverse metabolic outcomes at birth compared to infants of overweight/obese multiparous women. [ABSTRACT FROM AUTHOR]

Bridging/foundation programmes are often provided by tertiary institutions to increase equity in access and academic performance of students from under-served communities. Little empirical evidence exists to measure the effectiveness of these bridging/foundation programmes on undergraduate academic outcomes. This research identifies the predictive effect of academic outcomes achieved within a bridging/foundation programme, targeted towards indigenous and ethnic minority students, on first-year degree-level outcomes. Overall performance within the bridging/foundation programme was positively associated with increasing Grade Point Average (GPA), ‘Core 4’ GPA and passing all courses in first year. However, mixed associations were identified between feeder bridging/foundation courses and their intended first year course counterparts. These findings support the continued provision of bridging/foundation education; however, curricular reform within the bridging/foundation programme was required. Key developments included: restructuring course delivery; increasing constructive alignment across the curriculum; increasing cultural content within western science-orientated courses; introduction of cross-curricular assessment and use of additional innovative teaching and learning activities. Additional challenges remain for degree programmes to explore how they can change in order to better support indigenous and ethnic minority student success within first-year tertiary study. [ABSTRACT FROM AUTHOR]

Objective: While there is an emerging role of pancreatic fat in the aetiology of type 2 diabetes mellitus (T2DM), its impact on the associated decrease in insulin secretion remains controversial. We aimed to determine whether pancreatic fat negatively affects β-cell function and insulin secretion in women with overweight or obesity but without T2DM. Methods: 20 women, with normo- or dysglycaemia based on fasting plasma glucose levels, and low (< 4.5%) vs high (≥ 4.5%) magnetic resonance (MR) quantified pancreatic fat, completed a 1-hr intravenous glucose tolerance test (ivGTT) which included two consecutive 30-min square-wave steps of hyperglycaemia generated by using 25% dextrose. Plasma glucose, insulin and C-peptide were measured, and insulin secretion rate (ISR) calculated using regularisation deconvolution method from C-peptide kinetics. Repeated measures linear mixed models, adjusted for ethnicity and baseline analyte concentrations, were used to compare changes during the ivGTT between high and low percentage pancreatic fat (PPF) groups. Results: No ethnic differences in anthropomorphic variables, body composition, visceral adipose tissue (MR-VAT) or PPF were measured and hence data were combined. Nine women (47%) were identified as having high PPF values. PPF was significantly associated with baseline C-peptide (p = 0.04) and ISR (p = 0.04) in all. During the 1-hr ivGTT, plasma glucose (p<0.0001), insulin (p<0.0001) and ISR (p = 0.02) increased significantly from baseline in both high and low PPF groups but did not differ between the two groups at any given time during the test (PPF x time, p > 0.05). Notably, the incremental areas under the curves for both first and second phase ISR were 0.04 units lower in the high than low PPF groups, but this was not significant (p > 0.05). Conclusion: In women with overweight or obesity but without T2DM, PPF did not modify β-cell function as determined by ivGTT-assessed ISR. However, the salient feature in biphasic insulin secretion in those with ≥4.5% PPF may be of clinical importance, particularly in early stages of dysglycaemia may warrant further investigation. [ABSTRACT FROM AUTHOR]

In bio-medical mobile workstations, e.g., the prevention of epidemic viruses/bacteria, outdoor field medical treatment and bio-chemical pollution monitoring, the conventional bench-top microscopic imaging equipment is limited. The comprehensive multi-mode (bright/dark field imaging, fluorescence excitation imaging, polarized light imaging, and differential interference microscopy imaging, etc.) biomedical microscopy imaging systems are generally large in size and expensive. They also require professional operation, which means high labor-cost, money-cost and time-cost. These characteristics prevent them from being applied in bio-medical mobile workstations. The bio-medical mobile workstations need microscopy systems which are inexpensive and able to handle fast, timely and large-scale deployment. The development of lightweight, low-cost and portable microscopic imaging devices can meet these demands. Presently, for the increasing needs of point-of-care-test and tele-diagnosis, high-performance computational portable microscopes are widely developed. Bluetooth modules, WLAN modules and 3G/4G/5G modules generally feature very small sizes and low prices. And industrial imaging lens, microscopy objective lens, and CMOS/CCD photoelectric image sensors are also available in small sizes and at low prices. Here we review and discuss these typical computational, portable and low-cost microscopes by refined specifications and schematics, from the aspect of optics, electronic, algorithms principle and typical bio-medical applications. [ABSTRACT FROM AUTHOR]

ObjectiveTo compare the nutrient profile of packaged supermarket food products available in Australia and New Zealand. Eligibility to carry health claims and relationship between nutrient profile score and nutritional content were also evaluated.DesignNutritional composition data were collected in six major Australian and New Zealand supermarkets in 2012. Mean Food Standards Australia New Zealand Nutrient Profiling Scoring Criterion (NPSC) scores were calculated and the proportion of products eligible to display health claims was estimated. Regression analyses quantified associations between NPSC scores and energy density, saturated fat, sugar and sodium contents.ResultsNPSC scores were derived for 23 596 packaged food products (mean score 7·0, range −17 to 53). Scores were lower (better nutrient profile) for foods in Australia compared with New Zealand (mean 6·6 v. 7·8). Overall, 45 % of foods were eligible to carry health claims based on NPSC thresholds: 47 % in Australia and 41 % in New Zealand. However, less than one-third of dairy (32 %), meat and meat products (28 %) and bread and bakery products (27·5 %) were eligible to carry health claims. Conversely, >75 % of convenience food products were eligible to carry health claims (82·5 %). Each two-unit higher NPSC score was associated with higher energy density (78 kJ/100 g), saturated fat (0·95 g/100 g), total sugar (1·5 g/100 g) and sodium (66 mg/100 g; all P values<0·001).ConclusionsFewer than half of all packaged foods available in Australia and New Zealand in 2012 met nutritional criteria to carry health claims. The few healthy choices available in key staple food categories is a concern. Improvements in nutritional quality of foods through product reformulation have significant potential to improve population diets. [ABSTRACT FROM AUTHOR]

Objective: To compare the nutrient profile of packaged supermarket food products available in Australia and New Zealand. Eligibility to carry health claims and relationship between nutrient profile score and nutritional content were also evaluated.Design: Nutritional composition data were collected in six major Australian and New Zealand supermarkets in 2012. Mean Food Standards Australia New Zealand Nutrient Profiling Scoring Criterion (NPSC) scores were calculated and the proportion of products eligible to display health claims was estimated. Regression analyses quantified associations between NPSC scores and energy density, saturated fat, sugar and sodium contents.Results: NPSC scores were derived for 23,596 packaged food products (mean score 7.0, range -17 to 53). Scores were lower (better nutrient profile) for foods in Australia compared with New Zealand (mean 6.6 v. 7.8). Overall, 45% of foods were eligible to carry health claims based on NPSC thresholds: 47% in Australia and 41% in New Zealand. However, less than one-third of dairy (32%), meat and meat products (28%) and bread and bakery products (27.5%) were eligible to carry health claims. Conversely, >75% of convenience food products were eligible to carry health claims (82.5%). Each two-unit higher NPSC score was associated with higher energy density (78 kJ/100 g), saturated fat (0.95 g/100 g), total sugar (1.5 g/100 g) and sodium (66 mg/100 g; all P values<0.001).Conclusions: Fewer than half of all packaged foods available in Australia and New Zealand in 2012 met nutritional criteria to carry health claims. The few healthy choices available in key staple food categories is a concern. Improvements in nutritional quality of foods through product reformulation have significant potential to improve population diets. [ABSTRACT FROM AUTHOR]

Children born very preterm can demonstrate social-cognitive impairments, which may result from limbic system dysfunction. Altered development of the subnuclei of the amygdala, stress-sensitive regions involved in emotional processing, may be key predictors of social-skill development. In a prospective cohort study, 7-year-old children born very preterm underwent neurodevelopmental testing and brain MRI. The Child Behavioral Checklist was used to assess social–emotional outcomes. Subnuclei volumes were extracted automatically from structural scans (n  = 69) and functional connectivity (n  = 66) was examined. General Linear Models were employed to examine the relationships between amygdala subnuclei volumes and functional connectivity values and social–emotional outcomes. Sex was a significant predictor of all social–emotional outcomes (P  < 0.05), with boys having poorer social–emotional outcomes. Smaller right basal nuclei volumes (B  = -0.043, P  = 0.014), smaller right cortical volumes (B  = -0.242, P  = 0.02) and larger right central nuclei volumes (B  = 0.85, P  = 0.049) were associated with increased social problems. Decreased connectivity strength between thalamic and amygdala networks and smaller right basal volumes were significant predictors of greater social problems (both, P  < 0.05), effects which were stronger in girls (P  = 0.025). Dysregulated maturation of the amygdala subnuclei, along with altered connectivity strength in stress-sensitive regions, may reflect stress-induced dysfunction and can be predictive of social–emotional outcomes. [ABSTRACT FROM AUTHOR]

There is increasing evidence that the sex of the foetus may alter the maternal metabolic milieu during pregnancy. Following a randomized controlled trial of exercise in overweight and obese pregnant women, we assessed whether the sex of the foetus was associated with changes in maternal metabolism. Data were analysed on 74 randomized participants who completed the trial, including 38 mothers carrying males and 36 mothers carrying females. At 19 weeks of gestation, mothers carrying boys had higher blood glucose concentrations than those carrying girls (5.4 vs 4.9 mmol/l;p = .046). At 36 weeks of gestation, differences were more marked, with blood glucose concentrations 15% higher in mothers carrying females (5.7 vs 5.0 mmol/l;p = .004). In addition, mothers carrying girls had higher concentrations of hs-CRP across pregnancy (5.0 vs 3.6 mg/l;p = .029). Our findings provide further evidence that the sex of the foetus appears to influence maternal metabolism. [ABSTRACT FROM PUBLISHER]

Highlights: [•] Screen-based activities increase dietary intake in the absence of TV advertising [•] Studies have focused on the effects of TV rather than computer and video games [•] Limited data on comparative effects of different screens on acute dietary intake [•] Energy intake greater during TV watching than computer use [•] No difference in energy intake between computer use and video game play [Copyright &y& Elsevier]

Clinical relevance: Home-based videogame treatments are increasingly popular for amblyopia treatment. However, at-home treatments tend to be done in short sessions and with frequent disruptions, which may reduce the effectiveness of binocular visual stimulation. These treatment adherence patterns need to be accounted for when considering dose-response relationships and treatment effectiveness. Background: Home-based videogame treatments are increasingly being used for various sensory conditions, including amblyopia ('lazy eye'), but treatment adherence continues to limit success. To examine detailed behavioural patterns associated with home-based videogame treatment, we analysed in detail the videogame adherence data from the Binocular tReatment of Amblyopia with VideOgames (BRAVO) clinical trial (ACTRN12613001004752). Methods: Children (7-12 years), teenagers (13-17 years) and adults (≥ 18 years) with unilateral amblyopia were loaned iPod Touch devices with either an active treatment or placebo videogame and instructed to play for a total of 1-2 hours/day for six weeks at home. Objectively-recorded adherence data from device software were used to analyse adherence patterns such as session length, daily distribution of gameplay, use of the pause function, and differences between age groups. Objectively-recorded adherence was also compared to subjectively-reported adherence from paper-based diaries. Results: One hundred and five of the 115 randomised participants completed six weeks of videogame training. Average adherence was 65% (SD 37%) of the minimum hours prescribed. Game training was generally performed in short sessions (mean 21.5, SD 11.2 minutes), mostly in the evening, with frequent pauses (median every 4.1 minutes, IQR 6.1). Children played in significantly shorter sessions and paused more frequently than older age groups (p < 0.0001). Participants tended to over-report adherence in subjective diaries compared to objectively-recorded gameplay time. Conclusion: Adherence to home-based videogame treatment was characterised by short sessions interspersed with frequent pauses, suggesting regular disengagement. This complicates dose-response calculations and may interfere with the effectiveness of treatments like binocular treatments for amblyopia, which require sustained visual stimulation. [ABSTRACT FROM AUTHOR]

In this letter, a rectangular‐cavity‐like structure is proposed to feed the phase gradient metasurface (PGM), where two symmetrical long slots are cut on side walls along wave propagation direction of the rectangular waveguide cavity resonator. It consists of rectangular waveguide, transition section, slotted‐waveguide feed section, and shorted end of the cavity. The PGMs are placed in the slotted‐waveguide section and the slot is wide enough to accommodate PGMs. The antenna prototype is fabricated and measured whose measurements agree well with simulations in 7.8–11.0GHz. [ABSTRACT FROM AUTHOR]

Background: Reducing health inequalities requires interventions that work as well, if not better, among disadvantaged populations. The aim of this study was to determine if the effects of price discounts and tailored nutrition education on supermarket food purchases (percentage energy from saturated fat and healthy foods purchased) vary by ethnicity, household income and education. Method: A 2×2 factorial trial of 1104 New Zealand shoppers randomised to receive a 12.5% discount on healthier foods and/or tailored nutrition education (or no intervention) for 6 months. Results: There was no overall association of price discounts or nutrition education with percentage energy from saturated fat, or nutrition education with healthy food purchasing. There was an association of price discounts with healthy food purchasing (0.79 kg/week increase; 95% CI 0.43 to 1.16) that varied by ethnicity (p=0.04): European/other 1.02 kg/week (n=755; 95% CI 0.60 to 1.43); Pacific 1.20 kg/week (n=101; 95% CI 0.06 to 2.34); Maori --0.15 kg/week (n=248; 95% CI --1.10 to 0.80). This association of price discounts with healthy food purchasing did not vary by household income or education. Conclusions: While a statistically significant variation by ethnicity in the effect of price discounts on food purchasing was found, the authors caution against a causal interpretation due to likely biases (eg, attrition) that differentially affected Maori and Pacific people. The study highlights the challenges in generating valid evidence by social groups for public health interventions. The null findings for tailored nutritional education across all social groups suggest that structural interventions (such as price) may be more effective. [ABSTRACT FROM AUTHOR]

: This study sought to integrate perceived and built environmental and individual factors into the Theory of Planned Behavior (TPB) model to better understand adolescents' physical activity. Methods: Participants (n = 110) aged 12 to 17 years (M = 14.6 ± 1.55) were recruited from two large metropolitan high schools in Auckland, New Zealand, were included in the analysis. Participants completed measures of the revised TPB and the perceived environment. Individual factors such as ethnicity and level of deprivation were also collected. Geographical Information Systems (GIS) software was used to measure the physical environment (walkability, access to physical activity facilities). Physical activity was assessed using the ActiGraph accelerometer and the Physical Activity Questionnaire for Adolescents (PAQ-A). Data from the various sources were combined to develop an integrated model integrated for statistical analysis using structural equation modeling. Results: The TPB model variables (intention and perceived behavioral control) explained 43% of the variance of PAQ-A. Unique and individual contributions were made by intention and PBC and home ownership of home equipment. The model explained 13% of time spent in moderate and vigorous physical activity (Actigraph). Unique and individual contribution was made by intention. Conclusion: Social cognitive variables were better predictors of both subjective and objective physical activity compared to perceived environmental and built environment factors. Implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

Clinical relevance: Home-based videogame treatments are increasingly popular for amblyopia treatment. However, at-home treatments tend to be done in short sessions and with frequent disruptions, which may reduce the effectiveness of binocular visual stimulation. These treatment adherence patterns need to be accounted for when considering dose-response relationships and treatment effectiveness.Background: Home-based videogame treatments are increasingly being used for various sensory conditions, including amblyopia ('lazy eye'), but treatment adherence continues to limit success. To examine detailed behavioural patterns associated with home-based videogame treatment, we analysed in detail the videogame adherence data from the Binocular tReatment of Amblyopia with VideOgames (BRAVO) clinical trial (ACTRN12613001004752).Methods: Children (7-12 years), teenagers (13-17 years) and adults (≥ 18 years) with unilateral amblyopia were loaned iPod Touch devices with either an active treatment or placebo videogame and instructed to play for a total of 1-2 hours/day for six weeks at home. Objectively-recorded adherence data from device software were used to analyse adherence patterns such as session length, daily distribution of gameplay, use of the pause function, and differences between age groups. Objectively-recorded adherence was also compared to subjectively-reported adherence from paper-based diaries.Results: One hundred and five of the 115 randomised participants completed six weeks of videogame training. Average adherence was 65% (SD 37%) of the minimum hours prescribed. Game training was generally performed in short sessions (mean 21.5, SD 11.2 minutes), mostly in the evening, with frequent pauses (median every 4.1 minutes, IQR 6.1). Children played in significantly shorter sessions and paused more frequently than older age groups (p < 0.0001). Participants tended to over-report adherence in subjective diaries compared to objectively-recorded gameplay time.Conclusion: Adherence to home-based videogame treatment was characterised by short sessions interspersed with frequent pauses, suggesting regular disengagement. This complicates dose-response calculations and may interfere with the effectiveness of treatments like binocular treatments for amblyopia, which require sustained visual stimulation. [ABSTRACT FROM AUTHOR]